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Repairing mental health system high on lawmakers' minds

Columbian - 1/13/2019

Jan. 13--In the weeks leading up to the 2019 Washington legislative session, lawmakers' do-to lists only got longer.

During the 105-day "long session" that begins Monday, legislators were already expected to perform the heavy lift of hammering out two-year operating, transportation and capital budgets that fund state government.

In anticipation of the session, Democratic Gov. Jay Inslee, who is eyeing a presidential bid, laid out his own ambitious plans to address the state's opioid crisis, promote clean energy, expand health care and overhaul the state's troubled mental health system. He also rolled out his proposed $54.4 billion budget that included a new capital gains tax and business tax hikes that he said are needed to meet the state's constitutional and moral obligations.

After expanding their majority to 28-21 in the Senate and 57-41 in the House following the November election, legislative Democrats have also signaled their priorities on affordable housing, health care and other issues.

The party's ascendant position in the Legislature is good news for the three Democrats in Clark County's delegation. And while this session might look like a tough environment for the GOP, local Republican lawmakers, who dominate Clark County's delegation, said they won't pursue any sweeping ideological legislation. Instead, they'll work on narrowly focused, bipartisan bills while also playing defense on new taxes and regulations.

"We are working for Clark County as a delegation," said state Sen. Lynda Wilson, R-Vancouver. "And we will continue to work with (Democrats) even though we are in the minority."

Clark County legislators will hold leadership posts in both chambers and on key committees. The delegation has touted its cohesion and willingness to collaborate to advance the area's interests. This year, they'll continue work on replacing the Interstate 5 Bridge while also making sure the county benefits from reforms to the mental health care system.

Sen. Annette Cleveland, D-Vancouver, pointed out that negotiating an education funding package to satisfy the McCleary court ruling consumed much of 2017's marathon legislative session. She said fixes to mental health could occupy a similar spot in 2019.

"Day one (of the session), you always feel like you have all this benefit of time you don't have in the 60-day session," said. "But I know it's going to be fast and furious."

Mental health

Speaking at a press conference last month at the Navos Mental Health and Wellness Center in Burien, Inslee laid out his plan to bring mental health care into "this century."

Inslee's plan to revamp the state's mental health care system centers on moving civil commitment patients from Western State Hospital, the state's largest inpatient psychiatric facility, to more community-based centers. The move is expected to improve patients' recovery by being closer to their families and support networks.

Inslee's plan includes $675 million in his proposed budget and comes after months of bad headlines for Western State, which serves patients from Clark County and across the state. It was decertified by the Centers for Medicaid and Medicare Services in July despite efforts by state officials to improve conditions in the Pierce County facility.

Rep. Sharon Wylie, D-Vancouver, said that this legislative session has the potential to keep a "promise made 40 years ago," referring to a decades-old movement to bring mental health patients out of institutions and into community settings.

Clark County is seeking $1.75 million from the state's capital budget to fund the Vancouver Housing Authority'sTenny Creek community-based mental health facility. Vancouver Housing Authority Executive Director Roy Johnson said that funding for the $13 million facility will be stitched together with tax credits, federal funds and other sources. He didn't have an exact location for where the facility will be built, but said it will provide housing for about 40 tenants with ties to Clark County and will include a kitchen, exam room and space for supportive services.

Under the governor's plan, these new community-based facilities would provide options for people ready to be discharged from Western State and would reduce the wait lists for treatment.

"The thing that everyone wants to avoid is giving someone a life sentence to a psychiatric hospital," said longtime housing advocate Andy Silver, who is heading up the Housing and Health Innovation Partnership between local governments and nonprofits in Clark County.

In 2016, the housing authority opened Lincoln Place, a facility to house chronically homeless people, almost all with complex problems. Silver said that both Lincoln Place and Tenny Creek would provide supportive housing meant to keep vulnerable people stably housed. Unlike Lincoln Place, he said that Tenny Creek will have assisted-living services.

Silver said that the facility would help fill a big gap in the county's social services network for people with complex behavioral health challenges. He also pointed to a program run by the state Department of Commerce that helps pay for housing for people receiving long-term behavioral health services. He said the governor's proposed budget calls for an increase in funding for this program that could be hugely helpful in Clark County.

Clark County got some additional services with the 2018 opening of Rainier Springs, a privately owned behavioral health hospital. But Silver said it isn't a long-term residential setting and doesn't provide supportive housing like Tenny Creek would offer.

"We are going to have to continue to build a network of services in the county," said Rep. Monica Stonier, D-Vancouver, who also said she wants more mental health resources to be directed to kids in schools.

Peggy McCarthy, executive director of the Southwest Washington chapter of the National Alliance on Mental Illness, said that the Legislature has passed bills intended to enhance mental health services in schools and provide training for law enforcement officers. She hopes these bills receive funding this session.

Both Sen. Ann Rivers, R-La Center, and Wilson agreed that mental health reforms are needed. But Rivers said that disagreements could emerge about the level of funding necessary. Rep. Vicki Kraft, R-Vancouver, said she hopes that the overhaul of the mental health system is applied with flexibility and will allow a role for nonprofits and faith-based groups.

"If we think government can take care of this by itself we are mistaken," she said.

Cleveland could have a large role in the reforms as chair of the Senate Health and Long Term Care Committee. She said that the committee was recently reorganized to include behavioral health and that her key concern will be not leaving people without resources.

A bridge to cross

Cleveland has joked that she doesn't want to be known as the "bridge lady." But she said that I-5 Bridge will be on her mind in the upcoming session.

Since the Columbia River Crossing, a controversial replacement for the I-5 Bridge, died in the Legislature in 2013, Clark County legislators have been steadily the laying the groundwork to try again to replace the outmoded crossing.

In December, their efforts reached a milestone when a group of reluctant Oregon lawmakers met with their Washington counterparts to discuss replacing the century-old bridge. Later that month, Inslee signaled his interest by including $17.5 million to fund an office for the bridge replacement project. Inslee's budget line included the assumption that the new bridge would include light rail, which has been insisted upon by Oregon Gov. Kate Brown.

With the exception of Kraft, all of Clark County's legislative Republicans support the effort to replace the bridge. Instead of light rail, which remains controversial in Clark County, they've called for bus rapid transit to be included as the mass transit option.

"His budget is merely a suggestion to us," said Rivers. "I didn't read it as light rail definitely has to be on the bridge."

Stonier said that because Southwest Washington's legislative delegation got in the way of the last attempt to replace the bridge, area lawmakers need to clearly show their Oregon counterparts that they're on board. She said that while Kraft has been "respectfully participating," she's an outlier in the delegation by supporting a third bridge across the Columbia River.

"We need to be moving ahead on a third bridge and more capacity now," said Kraft.

Kraft said she heard from voters during her last campaign that commuters want more capacity to drive to work in their cars. She said she wants to make sure their voices are heard and will try to get a third crossing included as part of a deal with Oregon to replace the I-5 Bridge.

Cleveland said that in addition to getting funding for the project office the next step is passing legislation (which stalled last session) that will allow the new bridge project to be deemed a "project of statewide significance," expediting its planning and permitting needs. The Oregon Legislature also needs to formalize its participation in talks to replace the I-5 Bridge.

"Transportation projects have a long lead-up for anything," said Wylie, who noted her position as vice chair of the House Transportation Committee.

Minority report

Clark County's Democrats will have expanded clout as their party has more control in Olympia. Stonier, who will serve as House floor leader, said she'll introduce a bill to increase Medicaid reimbursements and will work on adjustments to education funding. Cleveland plans to launch an ambitious agenda from the Senate Health and Long Term Care Committee. Wylie said she'll introduce legislation to expedite renewable energy projects and cap the amount of money that can be donated in port commission races.

Clark County's legislative Republicans said that they're optimistic they can get smaller, targeted bills passed while also opposing tax hikes.

"I don't know if I can offer you a cure for world hunger yet," joked newly elected Republican Larry Hoff, who won retiring Liz Pike's House seat. He said he's hoping to work on improvements to the I-5 corridor while also scrutinizing tax increases as a "conservative watchdog."

Wilson said she'll try again on a bill intended to make it easier to goad people into getting their vehicles licensed after moving to Washington. She said she'll also introduce a bill changing the state's land-use laws to allow extension of sewer services to outlying areas in some circumstances.

Rep. Brandon Vick, R-Felida, said it's easier to get bills passed if you bring "real solutions instead of lobbing grenades." He said that after a spike in property taxes to pay for an education funding package there is a broad desire by lawmakers to provide relief. Kraft said she's also forged bipartisan ties while working on anti-sex trafficking legislation she'll continue pursuing.

"Bipartisanship shouldn't be something that just minorities talk about," said Rivers, who plans to introduce a range of bills on homeowners associations, cougar tracking, regulations for pedicurists and others. "It's something you've fostered while you're in the majority and the fates turn all the time."

Rivers and Kraft both question if there is enough appetite for tax increases even with Democrats in control. They raised the possibility of the Legislature going into special session.

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